JENNIFER R. BOOZER D.O. INC. NPI 1003148081

NPI Information

  • NPI: 1003148081
  • Provider Name: JENNIFER R. BOOZER, D.O., INC.
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: GRANITE CREEK FAMILY MEDICINE
  • Address: 1601 MONTE VISTA AVE
    SUITE 260
    CLAREMONT, CA
    ZIP 91711
  • Phone: (909) 450-1571

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NPI Details

JENNIFER R. BOOZER, D.O., INC. is a primary care clinic center in Claremont, CA. JENNIFER R. BOOZER, D.O., INC. NPI is 1003148081. The provider is registered as an organization entity type.
The provider Is Doing Business As Granite Creek Family Medicine.

The provider's business location address is:

1601 MONTE VISTA AVE
SUITE 260
CLAREMONT, CA
ZIP 91711-962
Phone: (909) 450-1571
Fax: (909) 579-0100

The provider's authorized official is Jennifer Rose Boozer .
The authorized official title is President and has the following contact phone number (909) 450-1571.

The enumeration date for this NPI number is 2/2/2010 and was last updated on 2/2/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary Care2OA8927CALIFORNIAYes

What is NPI?

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This page was last updated on: 3/30/2025

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